Objective To investigate the diagnostic status of colorectal cancer (CRC) and the influence of early diagnosis and cancer stage in a tertiary care hospital in China. Methods Face‐to‐face interviews were conducted in 364 consecutive CRC patients who had never participated in CRC screening. Initial symptoms, diagnosis and treatment delay were determined using a questionnaire. Factors influencing diagnostic status were analyzed using univariate analysis and logistic regression model. Results A total of 307 patients were enrolled, in which 128 were with colon cancer and 179 with rectal cancer. The duration of diagnosis delay was significant longer than that of treatment delay. Unlike rectal cancer, colon cancer was likely to be treated at an advanced stage with a short interval between symptom onset and treatment. Colon cancer patients with a history of biliary tract or gallbladder stones, aged ≥ 50 years and with abdominal mass or intestinal obstruction as the initial symptom were diagnosed and treated much earlier. In rectal cancer, women and non‐smokers were diagnosed and treated quickly. Factors correlated with early cancer stage were found in colon cancer, including bloody stool as the initial symptom (OR = 2.63, 95% CI 1.08–6.25, P = 0.034) and a history of appendectomy (OR = 4.00, 95% CI 1.15–14.29, P = 0.029). Conclusions The factors contributing to early cancer detection were identified but their clinical value is limited. Diagnosis by symptoms suggesting CRC needs to be improved and CRC screening should be vigorously promoted.
Presacral lesions are likely to be multiple, lobulated, infected, ruptured, and adhesive to the sacrococcyx and rectum, which contribute to the high local recurrence rate. Preoperative CT/MRI/ERUS and careful intraoperative exploration are required to direct surgical treatment and to reduce local recurrence. Optimal selection of surgical approach also is very important to reduce local recurrence. Presacral lesions attached to the sacrococcyx or rectum require simultaneous partial resection of the sacrococcyx or rectum to reduce local recurrence.
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